Only half of the physicians in both specialties said they were able to teach patients how to monitor their own blood glucose, and nearly two-thirds said they couldn't provide medical nutrition therapy.

Most cited a lack of time and/or low reimbursement rates for these and other services as reasons for the incomplete care, Pozniak and colleagues said.

"Physicians compensate for low reimbursement levels in a variety of ways, including spending less time with each patient, seeing more patients each day, prioritizing the most important aspects of diabetes care on a given visit, and scheduling more follow-up appointments," the researchers wrote.

For every one of 10 categories of diabetes care, more than two-thirds of respondents said reimbursements were inadequate from the three major types of payers: Medicare, Medicaid, and private insurance.

Medicaid had the worst reputation among the doctors surveyed, with at least 92% saying reimbursements were too low in nine of the 10 categories.

The survey found few major differences between the primary care physicians and endocrinologists. Two exceptions were the proportions reporting they provided diabetes self-management education (70% of primary care doctors versus 48% of endocrinologists) and medical nutrition therapy (41% of primary care physicians versus 16% of endocrinologists).

Physicians in the Novo Nordisk-funded survey were a convenience sample, recruited by the online medical information company Epocrates to respond to periodic surveys.

Twelve other physicians participated in an online focus group to detail their attitudes about barriers to providing comprehensive diabetes care.